In the medical field—and, in particular, in the field of endoscopic laser surgery—the positioning and aiming of a laser beam are carried out by using an optical fiber moved by the surgeon, with or without robotic assistance. Therefore, laser ablation or cutting procedures are generally carried out in a “point-by-point” manner, which results in poor uniformity and precision in performing these operations.
The laser surgical systems offering the best quality results, on the other hand, typically use a scanning technology, which means that the laser beam is automatically moved along a predetermined trajectory. By employing these devices, the uniformity and homogeneity of the cuts performed using laser are high-quality, involving reduced tissue carbonization and consequently minimal thermal damage. Clearly, these aspects are extremely important and significant in surgical applications.
However, the systems adopting the above-mentioned laser scanning technology are operated from outside the patient's body and therefore require a direct line of sight from the actuation unit to the surgical site, which makes them unsuited for endoscopic surgery, unless appropriate solutions are adopted.
For this reason, in the technical field, in particular in the endoscopic field, distal modules have been adopted which can be associated with medical devices, are designed to perform different scanning operations in narrow and confined spaces and can be used either in the surgical field or simply for diagnostic purposes. For example, these distal scanning modules can be equipped, in correspondence to their tip, with an endoscopic tool designed to detect images or to aim a laser beam for the purpose of performing a tissue ablation procedure.
In this way, it is not necessary to provide a direct line of sight in surgical operations any more, because a distal scanning module of this type allows the optical detection of areas or segments of the body cavity in which the surgical operation is to be performed. Therefore, the applicability of laser technology is extended to the endoscopic field, because by using the distal scanning module it is possible to achieve a high degree of precision and minimal invasiveness.
A few prior art documents referring to the use of distal scanning modules are mentioned hereinafter.
Patent WO 2010/042611 discloses a distal scanning module. In particular, said document describes systems, devices and methods for providing insert able and adjustable robotic sensory with manipulation platforms for the so-called “single port” surgery. This invention features an insertable device that provides visual feedback upon insertion and implements a structure having a primary backbone and four secondary backbones for each of the robotic arms. It also implements a radial expansion mechanism that can separate the robotic arms. All of these elements together provide an anthropomorphic endoscopic device.
Patent EP 1 695 655 discloses a flexible tip of an endoscopic system which controls the degree of bending and which can be used for inspection and medical treatment. Said invention comprises a main tube connected to the tip and the tip comprises a working channel tube connected to the main tube. It is also provided with a bending mechanism to support and bend the working channel tube and there are one or more weights attached to the outer surface of the bending mechanism, as well as an outer skin tube to cover the outer surface of the bending mechanism together with the weights. The bending mechanism includes a coil acting as a shape-memory actuator and arranged in the longitudinal direction of the working channel tube. Thanks to this structure, it is possible to direct the active tube by driving the bending mechanism on the end side of the active tube and by bending it arbitrarily in the desired angle and direction, in order to improve the insertion ability into difficult locations.